CHAPTER 774: AORTIC RUPTURE—DON’T PERFORM EXTERNAL CARDIAC MASSAGE!

Garrett cursed loudly, dropping to his knees. The sharp beeping of the ECG cloud screen and the blood pressure magic monitor pierced his ears, almost merging into a continuous line—

Arrhythmia!

Arrhythmia!

Blood pressure 70/50!

60/30!

Systolic at 35, diastolic undetectable!

Damn it!

Damn it!

Damn it!!!

Suspected aortic dissection, aneurysm, positional change, sudden collapse, arrhythmia, plummeting blood pressure—

So, what caused the patient to collapse? Did the change in position cause the blood pressure to spike, overstimulating the receptors, leading to a drop in blood pressure?

Cardiac tamponade?

Or even worse, aortic rupture, massive hemorrhage?

Garrett intently studied the ECG, his mind racing through the possibilities. On either side of him, two knights lunged forward, catching his father. They fumbled clumsily, shaking him vigorously:

"Father! What’s wrong with you?"

"Wake up, please!"

"How do we save him?"

"Right, how do we save him? External cardiac massage?—I’ll do it!"

As they spoke, they had already laid the old knight flat and unbuttoned his chest, tilting his head to one side. They checked his breathing and felt for his carotid pulse with practiced movements, something that made Garrett sure of one thing:

After taking his first aid manual, the Temple of the God of War indeed provided sufficient training to warriors, at least to knights. Those untrained wouldn’t think to clear the airway...

The two knights exchanged a glance, one stacking his hands and straightening his arms, ready to begin. The other pressed a palm against the ground, rising from his kneeling position to move across from the old knight, ready to take over at any moment.

Under other circumstances, Garrett would be thrilled to have such trained individuals take over. No need for him to press himself!

No need for him to use magic for compression!

Cardiopulmonary resuscitation, before the era of magic, always cost him half his life!

But not this time. Garrett roared, flinging his arm at the middle-aged knight:

"Don’t touch him! Pressing like this will kill him!"

Aortic dissection!

The presence of a dissection meant the tri-layered structure of the aorta was repeatedly stretched under high pressure, causing the connective tissues of the three layers to tear. The inner layer of the aorta was damaged, misdirecting blood flow between the inner and middle layers.

In his past life, Garrett had heard of the most extensive aortic dissections starting from the thoracic aorta all the way down to the abdominal aorta, almost reaching the iliac arteries.

External cardiac massage would apply immense additional pressure to the already fragile aorta, which might be down to its last layer or two. With bad luck, even the outermost layer could rupture—

Once it ruptures, massive hemorrhaging follows. Blood pumped from the heart, escaping through the aortic tear, would pour into the chest or abdominal cavity. Within a minute or two, the blood would be drained, beyond salvation.

Of course, there were relatives who strongly requested external massages. Garrett himself had answered questions from junior doctors before. Aortic dissection, with the heart ceasing to beat—should you press?

By the nature of the illness, pressing is utterly unhelpful. However, according to cardiac arrest protocols, not pressing is absolutely wrong, and relatives would think you didn’t fulfill your resuscitative duties.

Luckily, it hadn’t come to that yet. After being shouted at, the knights obediently stopped. Only the younger knight asked quietly:

"What should we do then..."

Garrett quickly cast a 【Heal Major Wounds】—a versatile emergency spell that effectively stabilizes blood pressure, heart rhythm, and vital signs. He then gestured for his oak staff, pointing it forward:

Below the staff’s green leaves, a small serpent transformed into a streak of light, diving into the old knight’s body. Garrett half-closed his eyes, connecting to the serpent’s perspective, guiding it swiftly forward:

Chest wall!

Ribs!

Pericardium!

In this situation, direct exploration by the spirit of the pact, more effective than any CT, enhanced CT, or bedside cardiac ultrasound, could actually see!

Through the ethereal eyes of the pact spirit, indeed, the pericardium was abnormally swollen. Further inside, was there any tamponade?

Thankfully, no!

Although there was effusion in the pericardium, it wasn’t enough to cause tamponade, compressing the heart and preventing it from beating.

—If it had come to that, just like that orc last time, he would have to open the chest wide, cut open the pericardium to decom

press, and perform direct cardiac massage. Whether a patient with concomitant aortic dissection could be saved in such a case, Garrett had no certainty in his heart.

He directed the serpent to circle both atria and ventricles, which, apart from the expected hypertrophy of the ventricles, looked good. Then, along the ascending aorta, upward—damn!!!

A massive tear!!!

With every heartbeat, bright red blood spurted out, flooding into the chest cavity. In the time it took to say these few sentences, the patient’s blood loss had reached critical levels!

Garrett took a deep breath, forcing himself to calm down. Don’t panic, don’t panic, this isn’t the past life, waiting for stent placement or open chest suturing, the patient would have been gone by then. With the healing spell, there was hope to seal this tear…

He extended his hand again, gently pressing it down. A dense white light fell into the elderly man’s chest, sinking continuously:

【Heal Major Wounds】!

I’m counting on you!

Garrett concentrated his mental energy, ensuring the healing spell didn’t dissipate. To the heart, don’t wander! Don’t disperse!

Maintaining the heart’s beating now made no sense, hurry and plug the tear…

The ethereal spirit of the pact silently moved in the old man’s chest, leading the healing spell forward. There, there, to the rupture in the ascending aorta, patch it up, let it grow toward the center! Hurry, hurry!

In the illusory gaze, the tear in the ascending aorta quickly climbed from both sides to the center. Two centimeters, one centimeter, five millimeters, closure! But it wasn’t enough, the tough three-layered inner lining of the aorta was down to its last layer, unable to withstand the immense pressure of the heart…

Garrett glanced at the ECG and blood pressure monitor, sinking his mind, directing the serpent back down. The torn aortic lining, was there a chance it could regrow to its original position?

Using the healing spell to call it, nurture it, letting it continue to climb upward, returning to the aorta!

Garrett had never known such refined use of the healing spell would test his mental strength so greatly. Mental energy leaked like a floodgate had opened, guiding the blood vessels to grow bit by bit, arranging the cells into the needed formation—

Fortunately, when he had built his meditation core in the past, he had repeatedly recalled the construction of the aorta, within that luminous human form, constructing three layers of connective tissue, dense and elastic, a robust vessel. Now, it was just doing it all over again.

Done!

Attached!

Fused!

The serpent continued downward, finding the end of the torn aorta—cut open, release the blood from the false lumen, increasing blood volume!

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